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Now the family lives in a camp for eastern Congo's growing legion of displaced people, a sprawling collection of canvas-covered shacks where hunger and disease are the worst killers.

This month Nirere helped bury an older sister who fell ill from malnutrition. Two days later, her 6-year-old, diarrhea-stricken brother, Habi, lay in a cot in the local clinic, his toothpick arms pierced by tubes pumping nutrients into his motionless body.

“We are dying,” Nirere, who has close-cropped hair and stoic, wide-set eyes, said simply.

The International Rescue Committee, a New York-based relief agency, says that although 45,000 people are dying every month – a mortality rate that's 60 percent higher than Africa's average – Congo remains a “forgotten crisis.”

The vast country, ruggedly beautiful and mineral-rich, has been a crucible of suffering for years, with the death toll from a civil war and the ensuing humanitarian crisis estimated to be the greatest of any conflict since World War II.

Now, a new round of fighting between government soldiers and the well-equipped army of a renegade general, Laurent Nkunda, is threatening the lives of hundreds of thousands more civilians in eastern Congo, the epicenter of the crisis.

Over the past two months, the fighting – which has its roots in the 1994 genocide in neighboring Rwanda – has killed at least 100 civilians and forced 250,000 from their homes, according to Human Rights Watch.

As a cease-fire between Nkunda's forces and the government nears collapse, aid workers say that civilians are at risk not just of getting caught in the crossfire but also of being attacked, raped or killed by soldiers on both sides.

Eastern Congo has been at the mercy of armed groups for more than a decade, since the end of the Rwandan genocide, when remnants of the Hutu militias that slaughtered some 800,000 Tutsis fled across the border into what was then called Zaire.

Nkunda launched his rebellion in large part to protect his Tutsi community from attacks by Hutus, although human rights groups say that as his ambitions have grown his army increasingly has been attacking civilians.

In 2006 Congo chose Joseph Kabila as its first democratically elected president in more than four decades.

However, the weaknesses of Kabila's government are epitomized by the Congolese army, an ill-paid conglomeration of one-time militias that are “prone to abandoning their posts and capitalizing on the chaos to loot and terrorize the population,” the relief group Refugees International wrote in a report last week.

Nkunda, a reedy man with a messianic streak, is unapologetic about the violence, which he says is necessary to liberate Congo from Kabila's corrupt government.

“That is the cost of freedom,” Nkunda said last week in the mountaintop town of Kitchanga, now controlled by his forces.